Comparison of Minced Cartilage Implantation Versus Microfracture for Acetabular Chondral Lesions Due to FAI (Femoro-acetabular Impingement) (CARTIFRAC)

A femoroacetabular impingement (FAI) is an abnormal contact between pelvis and the neck of femur. It occurs particularly when patient bends his hip and causes damage to the cartilage. In the long term, FAI can lead to the development of osteoarthritis (cartilage destruction) and may require a total hip replacement (THR).

Surgery to treat cartilage damage in the hip aims to maintain joint function and delay the onset of osteoarthritis. Microfracture remains the most commonly used treatment for cartilage lesions. It is a surgical technique for repairing articular cartilage that works by creating tiny fractures in the bone, which in turn stimulate the growth of new cartilage.

Cartilage autografting is a promising alternative to microfracture, offering good results in the knee joint. Cartilage autografting involves the use of autologous cartilage tissue (taken from patient body), which is harvested, ground up and reimplanted in a single surgical procedure to promote the growth of new cartilage and repair.

The published literature lacks large-scale studies comparing autologous cartilage transplantation with traditional joint-preserving surgeries, such as microfracture. This is the reason why this study is set up.

Study Overview

• Status: Not yet recruiting
• Conditions: Femoro-acetabular Impingement (FAI)
• Intervention / Treatment: Procedure: Minced cartilage implantation - MCI; Procedure: Microfracture

Detailed Description

Patients with femoro-acetabular impingement (FAI) often develop acetabular chondral lesions, which can impair joint function and reduce quality of life. If left untreated, chondral lesions can progress to osteoarthritis and thus require total hip arthroplasty.

Joint preservation surgeries for the treatment of hip chondral lesions, aim to maintain joint function and delay the onset of osteoarthritis. Microfracture remains the most commonly used treatment for chondral lesions.

Although microfracture is the reference surgical treatment for acetabular chondral lesions, several clinical studies and systematic reviews have reported higher rates of conversion to THA and lower patient-reported outcomes for microfracture compared to other techniques. Furthermore, microfracture can weaken subchondral bone and increase the formation of subchondral cysts, which may explain its inferior outcomes.

Minced cartilage implantation (MCI) has emerged as a promising alternative to microfracture, providing good outcomes in the knee joint. MCI involves the use of autologous cartilage tissue, which is harvested, minced, and re-implanted in a one-stage surgery to promote chondrogenesis and repair. Only one published study has reported on outcomes of MCI in the hip joint, showing good results for 11 male patients with FAI at 2 years follow-up. Therefore, the published literature lacks large-cohort studies that compare MCI to traditional joint preservation surgeries, such as microfracture.

This is the reason why this Clinical Study is set up. The hypothesis is that MCI will provide better short- to mid-term outcomes than microfracture in patients with acetabular chondral lesions due to FAI.

• Study Type: Interventional
• Enrollment (Estimated): 180
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Nicolas BONIN, MD; Phone Number: + 33 4 72 20 00 00; Email: dr.bonin@lyon-ortho-clinic.com

Study Locations

• France
  • Lyon, France, 69009
    • Clinique De La Sauvegarde
    • Contact: Nicolas BONIN, MD; Phone Number: + 33 4 72 20 00 00; Email: dr.bonin@lyon-ortho-clinic.com
  • Strasbourg, France, 67100
    • ICOSS
    • Contact: Michel RAHME, MD; Phone Number: +33 6 84 49 41 20; Email: dr.mrahme@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patient, male or female, aged 18-50 years old;
• Patient with an acetabular chondral lesion due to FAI, characterised as Beck class 4 or 5, measuring 1-6 cm2;
• Patient with Tönnis grade 0-2;
• Patient who signed the informed consent form and is willing to comply with the protocol requirements based on the investigator's judgment;
• Patient affiliated with a social security scheme;
• Patient able to answer questionnaires and to communicate freely in French

Exclusion Criteria:

• Patient with prior ipsilateral hip surgery;
• Patient with borderline or frank hip dysplasia (lateral centre edge angle <25º);
• Patient with hyperlaxity (Beighton score >7);
• Patient with any concomitant disease or disorder which, in the opinion of the investigator, may put the patient at risk or may influence the result of the study;
• Patient that is pregnant or breastfeeding;
• Patient with protected status under articles L1121-6, LL121-8 and L1122-2 of the French Public Health Code;
• Patient who cannot comply with the protocol requirements based on the investigator's judgment

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: MCI group; MCI involves the use of autologous cartilage tissue, which is harvested, minced, and re-implanted in a one-stage surgery to promote chondrogenesis and repair	Procedure: Minced cartilage implantation - MCI; Autologous minced cartilage will be harvested from the defect site and cam deformity area using a non-aggressive shaver blade . The cartilage will then be collected and augmented with platelet-rich plasma from the patient's blood. The platelet-rich plasma will be 100% autologous. Cautious debridement of the chondral lesion up to the stable chondral margins will be performed, followed by removal of the calcified subchondral bone layer, then the minced cartilage will be implanted on the acetabular chondral lesion using an application cannula.
Active Comparator: Microfracture group; Microfracture surgery is a surgical technique for repairing joint cartilage	Procedure: Microfracture; Microfracture surgery is a surgical technique that works by creating tiny fractures in the underlying bone. This stimulates the growth of new cartilage.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
International Hip Outcome Tool-12 (iHOT-12)	The iHOT-12 is a validated self-administered questionnaire that measures health-related quality of life and changes after hip preserving treatments, in young active patients with hip disorders [13]. The questionnaire comprises 12 items, covering four domains: (i) symptoms and functional limitations, (ii) sport and recreational activities, (iii) job-related concerns, and [14] social, emotional, and lifestyle concerns. Each item is scored using a visual analog scale (VAS) from 0 to 100, with a score of 100 being the best function and least amount of symptoms. The final iHOT score is calculated as the overall mean of all 12 items, ranging from 0 to 100	One year

Collaborators and Investigators

• Sponsor: GCS Ramsay Santé pour l'Enseignement et la Recherche

Study record dates

Study Major Dates

• Study Start (Estimated): July 1, 2026
• Primary Completion (Estimated): June 1, 2031
• Study Completion (Estimated): June 1, 2031

Study Registration Dates

• First Submitted: June 13, 2026
• First Submitted That Met QC Criteria: June 13, 2026
• First Posted (Actual): June 18, 2026

Study Record Updates

• Last Update Posted (Actual): June 18, 2026
• Last Update Submitted That Met QC Criteria: June 13, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: microfracture; FAI; Minced cartilage implantation
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Wounds and Injuries; Pathologic Processes; Joint Diseases; Fractures, Bone; Pathological Conditions, Signs and Symptoms; Femoracetabular Impingement; Fractures, Stress; Surgical Procedures, Operative; Arthroplasty; Orthopedic Procedures; Plastic Surgery Procedures; Arthroplasty, Subchondral
• Other Study ID Numbers: 2026-A00200-51

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No